Individual
ALEXA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
1807 W BROADWAY BLVD, SEDALIA, MO 65301-2566
(660) 826-2015
Mailing address
570 CARVED TER, COLORADO SPRINGS, CO 80919-1129
(719) 287-4467
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0005993
CO
225XH1200X
Hand Occupational Therapist
Primary
2022012872
MO
Other
Enumeration date
06/10/2019
Last updated
10/26/2022
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